Surgical rail apparatus for litter

ABSTRACT

An apparatus for mounting surgical rails to a litter having a pair of parallel poles includes a surgical rail fixed to a clamp. The clamp is fixed to one of the parallel poles. A cross bar extends between the clamp and a second clamp fixed to the other of the parallel poles.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application claims the benefit of priority of and is a continuation-in-part of U.S. non-provisional patent application Ser. No. 15/543,019 filed on Jul. 12, 2017, which is a 371 of PCT patent application PCT/US16/34897 having an international filing date of May 28, 2016, which claims priority to U.S. provisional patent application Ser. No. 62/168,953 filed on Jun. 1, 2015. The entire contents of all of the above-listed patent applications are expressly incorporated by reference herein.

STATEMENT OF GOVERNMENT INTEREST

The invention described herein may be manufactured, used and licensed by or for the United States Government.

BACKGROUND OF THE INVENTION

The invention relates in general to emergency medical care and in particular to apparatus for securely attaching medical/surgical devices to an injured person carrier, such as a litter or stretcher.

Every day people are injured, especially during armed conflicts, terrorism, accidents and natural disasters. The injuries may be serious and may require the injured person to be placed on a stretcher, litter or similar injured person carrier. An example of a litter is a NATO litter 10 shown in FIG. 1. The NATO litter 10 includes a pair of parallel poles 12 and a fabric that forms a bed 14 extending between the poles 12. The poles 12 may be made of, for example, wood or a metal such as aluminum. Litter 10 may include stirrups 16 for supporting the litter 10 on the ground or a platform. As seen in FIG. 3, litter 10 may also include cross beams 17 that extend under the bed 14 between opposing stirrups 16.

The injured person may receive medical attention at or near the geographical site of the injury and then be transported via a litter by foot, land vehicle, air vehicle or other transporter to a medical treatment facility. The injured person may require treatment and/or surgery before being transported to a medical treatment facility. Sometimes one or more medical and/or surgical devices are required for treatment and/or surgery for the injured person prior to and/or while being transported to a medical treatment facility. Such medical and/or surgical devices may include, for example, retractors, arm boards, IV poles, suction devices, lights, monitors and other devices.

To keep such medical/surgical devices close to the injured person, the medical/surgical devices may be somehow associated with the injured patient carrier. In combat areas, the transport of an injured person on a litter may be by two people who are walking or running over rough terrain, by a helicopter or other air vehicle that is subject to unpredictable air currents, by a military ambulance over rough terrain, or combinations of such transporters. The resulting ride could therefore be subject to unforeseen air currents or rapid aircraft movements that cause the aircraft to drop suddenly, make rapid and sharp turns and otherwise continue on its journey to transport the injured person(s) to a medical facility as quickly as possible. Such rapid transporter movements require that the medical/surgical devices are secured against reacting to the sudden change of movements and directions by flying off into space and/or within the transport vehicle and possibly further injuring the injured person or injuring persons who are assisting the injured person and/or flying or driving the transporter.

Some stretcher based operating tables, like the English table, do not enable the placement and use of self-retaining fixed retractors like the Bookwalter retractors. This limitation greatly inhibits the scope and ease of surgeries possible on these platforms. The placement of arm boards and leg/foot rests on stretcher based operating tables is possible but it is very limited and cumbersome. The SMEED (Special Medical Emergency Evacuation Device) platform and CMS MOJO™ ready station allow for attachment of multiple devices in multiple locations, but they do not allow for the attachment of a wide variety of surgical devices necessary for better exposure and ease of operation. While the SMEED allows for attachment of valuable monitoring devices necessary in an ICU or transport setting, it cannot accept attachments for surgical retractors and does not facilitate better exposure, positioning or ease of operation. The MOJO™ ready station allows for attachment of some devices like trays and lights, which may help in surgery, but does not allow for attachment of arm boards, retractors, and leg rests.

A need exists for an apparatus for securely fixing a wide variety of medical/surgical devices to a litter for use as an operating table and for transporting the litter along with the medical/surgical devices and the patient.

SUMMARY OF THE INVENTION

One aspect of the invention is an apparatus for use with a litter having a pair of parallel poles. The apparatus includes a longitudinal rectangular bar. A first clamp has a circular inner surface and an opening for receiving one of the pair of parallel poles. The first clamp is fixed to the longitudinal rectangular bar on a side of the first clamp that is opposite the circular inner surface. A second clamp has a circular inner surface and an opening for receiving the other of the pair of parallel poles. A cross bar extends between and is fixed to the first and second clamps.

The longitudinal rectangular bar may be a standard surgical rail.

Each clamp may include a threaded set screw for fixing the clamp to a respective one of the parallel poles.

The apparatus may include the litter wherein the longitudinal rectangular bar is disposed outboard of the one of the parallel poles. The first and second clamps are fixed to opposite ones of the parallel poles. The cross bar extends under a bed of the litter.

In one embodiment, each clamp includes a lock nut having a protuberance disposed in an opening in the cross bar for securing the cross bar to the clamp. The threaded set screw may engage a threaded opening in the lock nut.

Another aspect of the invention is an apparatus for use with a litter having a pair of parallel poles wherein the apparatus includes a longitudinal rectangular bar having male and female ends. The male end includes a pair of latch indentations and the female end includes a pair of spring-loaded latches. The pair of spring-loaded latches on the female end is configured to latch with a pair of latch indentations on a male end of a second rectangular bar. A clamp has a circular inner surface and an opening for receiving one of the pair of parallel poles. The clamp is fixed to the longitudinal rectangular bar on a side of the clamp that is opposite the circular inner surface.

A cross bar portion extends from the clamp and has an end distal the clamp. The distal end includes a projecting male portion and a recessed female portion. The projecting male portion is configured to mate with an opening in a recessed female portion of a second cross bar portion and the recessed female portion is configured to mate with a projecting male portion of the second cross bar portion.

The cross bar portion includes a latch receiver disposed on the projecting male portion and a latch disposed on the recessed female portion wherein the latch receiver and latch are configured to latch with a latch and latch receiver, respectively, on the second cross bar portion.

The invention will be better understood, and further objects, features and advantages of the invention will become more apparent from the following description, taken in conjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily to scale, like or corresponding parts are denoted by like or corresponding reference numerals.

FIG. 1 is a perspective view of a litter.

FIG. 2 is a perspective view of the litter of FIG. 1 with one embodiment of a surgical rail apparatus installed thereon.

FIG. 3 is a bottom perspective view of FIG. 2.

FIG. 4 is a top perspective view of one embodiment of a surgical rail apparatus without the litter.

FIG. 5 is a bottom perspective view of FIG. 4.

FIG. 6 is an exploded view of the surgical rail apparatus of FIG. 5.

FIG. 7 is a top perspective view of another embodiment of a surgical rail apparatus.

FIG. 7A is a top perspective view of a further embodiment of a surgical rail apparatus.

FIG. 8 is a bottom perspective view of FIG. 7A.

FIG. 9 is a top perspective view of the surgical rail apparatus of FIG. 7A installed on the litter of FIG. 1.

FIG. 10 is a bottom view of FIG. 9.

FIG. 11 is a top perspective view of another embodiment of a surgical rail apparatus.

FIG. 12 is a bottom perspective view of FIG. 11.

FIG. 13 is a top perspective view of the surgical rail apparatus of FIG. 11 installed on the litter of FIG. 1.

FIG. 14 is a bottom perspective view of FIG. 13.

FIG. 15A is a bottom plan view of FIG. 14.

FIG. 15B is an elevation view of FIG. 15A.

FIG. 15C is an enlarged view of Detail C of FIG. 15A.

FIG. 15D is an enlarged view of Detail D of FIG. 15B.

DETAILED DESCRIPTION

FIGS. 2 and 3 show one embodiment of a surgical rail apparatus 18 installed on a litter 10. Apparatus 18 is of use when installed on litter 10 of other patient carrier. For clarity, FIGS. 4-6 show the apparatus 18 without the litter 10.

Referring to FIGS. 4-6, surgical rail apparatus 18 includes a first longitudinal member 20 and a second longitudinal member 22 spaced apart from and parallel to the first longitudinal member 20. A first clamp 24 has a circular inner surface 32 a and an opening 34 a for receiving one of the pair of parallel poles 12. First clamp 24 is fixed to one end of the first longitudinal member 20 such that the opening 34 a faces the second longitudinal member 22. A second clamp 26 has a circular inner surface 32 b and an opening 34 b for receiving one of the pair of parallel poles 12. Second clamp 26 is fixed to another end of the first longitudinal member 20 such that the opening 34 b faces the second longitudinal member 22.

A third clamp 28 has a circular inner surface 32 c and an opening 34 c for receiving the other of the pair of parallel poles 12. Third clamp 28 is fixed to one end of the second longitudinal member 22 such that the opening 34 c faces the first clamp 24 on the first longitudinal member 20. A fourth clamp 30 has a circular inner surface 32 d and an opening 34 d for receiving the other of the pair of parallel poles 12. The fourth clamp 30 is fixed to another end of the second longitudinal member 22 such that the opening 34 d faces the second clamp 26 on the first longitudinal member 20.

A first cross bar 36 extends between and is fixed to the first and third clamps 24, 28. A second cross bar 38 extends between and is fixed to the second and fourth clamps 26, 30. A first rectangular bar 40 is spaced apart from and fixed to an outer surface 44 (FIG. 5) of the first longitudinal member 20. A second rectangular bar 42 is spaced apart from and fixed to an outer surface 46 of the second longitudinal member 22. In one preferred embodiment, the first and second rectangular bars 40, 42 are standard surgical rails. Standard surgical rails are known in the art and are able to receive and mount a wide variety of medical and surgical devices. Standard surgical rails have a rectangular cross-section. The North American standard surgical table side rail is 1.125 inches by 0.375 inches. The European standard surgical rail is 25 mm by 10 mm. As is known in the art, notches 48 may be formed in rails 40, 42 for ease of mounting and dismounting certain medical and surgical devices. The medical and surgical devices mounted on rails 40, 42 will be secure. The longitudinal members 20, 22 will not be subject to rotation about poles 12 or horizontal or vertical displacement.

The components of apparatus 18 may be made of, for example, aluminum. Aluminum is strong and light in weight. Minimizing weight is very important when apparatus 18 is used in far forward military areas where much gear must be carried by soldiers and motorized transport is not available or difficult to obtain. In one embodiment, the first and second longitudinal members 20, 22 are hollow members. Members 20, 22 may have various shaped cross-sections. In one preferred embodiment, the cross-sections of members 20, 22 are rectangular or square tubes. The weight of apparatus 18 may be further reduced by the use of lightening holes 50 in members 20, 22 and lightening holes 52 in cross members 36, 38. In one embodiment, first and second longitudinal members 20, 22 may have lengths in the range of about three feet to about four feet. Other lengths of first and second longitudinal members 20, 22 may be used depending on particular needs. Members 20, 22 should be at least as long as their corresponding rails 40, 42, for stability.

The detailed construction of one embodiment of apparatus 18 is best explained with reference to the exploded view shown in FIG. 6. The first longitudinal member 20 may comprise a sub-member 20 a with a female end 21 a and a sub-member 20 b with a male end 21 b. The male end 21 b may be fixed to sub-member 20 b using, for example, a fastener 54. Sub-member 20 b with male end 21 b fixed thereto is inserted in the female end 21 a of sub-member 20 a. Male end 21 b includes a latch 56 rotatably fixed in a latch housing 58 using a pin 60. Latch 56 is spring-loaded in housing 58 with spring 62. Male end 21 b is inserted in female end 21 a by depressing latch 56 using knob 64 which allows latch 56 to enter female end 21 a. Then, latch 56 snaps in a locked position in latch opening 68 in female end 21 a. Plugs 70 may be inserted in the other ends of sub-members 20 a and 20 b.

First rectangular bar 40 may include a pair of sub-bars 40 a, 40 b fixed to respective sub-members 20 a, 20 b. As noted above, sub-bars 40 a, 40 b are preferably standard surgical rails. Sub-bars 40 a, 40 b are spaced apart from sub-members 20 a, 20 b using a plurality of spacers 72. The spacers 72 create a gap between sub-members 20 a, 20 b and sub-bars 40 a, 40 b so that medical/surgical devices may be attached and mounted on sub-bars 40 a, 40 b. Sub-bars 40 a, 40 b may be fixed to respective sub-members 20 a, 20 b using, for example, a plurality of threaded fasteners 74.

As can be seen in FIG. 6, second longitudinal member 22 may comprise sub-members 22 a and 22 b with sub-bars 42 a and 42 b attached thereto. The construction and latching mechanism of sub-members 22 a and 22 b and the manner of attaching sub-bars 42 a and 42 b is similar to that of sub-members 20 a, 20 b and sub-bars 40 a, 40 b and, therefore, will not be described in detail again.

Cross bar 36 has flattened portions at each end with one flattened portion being a pivot end 78 and the other flattened portion being a slot end 80. Cross bar 38 similarly has flattened portions at each end with one portion being a pivot end 84 and the other portion being a slot end 82. Clamps 24, 26, 28 and 30 may be fixed to their respective sub-members 20 b, 20 a, 22 a, 22 b using, for example, fasteners 76. The tops (as viewed in FIG. 6) of clamps 24 and 30 include recessed portions 86 for receiving the pivot ends 78, 84 of their respective cross bars 36, 38. Clamps 28, 26 may have generally planar top portions for receiving the slot ends 80, 82 of the cross bars 36, 38. Clamps 24, 26, 28 and 30 may be fixed to parallel poles 12 of litter 10 using, for example, set screws 90 having turning knobs 92. It should be noted that the set screws 90 primarily constrain vertical translation of poles 12 in clamps 24, 26, 28 and 30 and the cross bars 36, 38 primarily constrain rotation of the sub-members 20 a, 20 b, 20 c and 20 d about the parallel poles 12.

The ends of cross bars 36, 38 may be fixed to clamps 24, 26, 28 and 30 using, for example, lock nuts 88. Each lock nut 88 includes a knob 94, a protuberance 96 beneath the knob 94, and a threaded through hole 98. Protuberances 96 may have smaller diameters than knobs 94 to facilitate grasping knobs 94 with one's fingers. Protuberances 96 are seated in openings 78 a, 80 a, 82 a, 84 a, in the flattened end portions of cross bars 36, 38. Lock nuts 88 are tightened using knob 94 to thread lock nuts 88 on set screws 90.

Apparatus 18 may be disassembled and transported in four parts or pieces, which makes assembly of apparatus 18 to a litter 10 easy. After some practice, apparatus 18 may be assembled to a litter 10 in 30 seconds or less. Referring to the view of FIG. 6, the four disassembled pieces each include one sub-member 20 a, 20 b, 22 a, or 22 b along with the sub-rail and clamp corresponding to that sub-member. The male ends of the sub-members 20 b and 22 b are disengaged from the corresponding female end sub-members 20 a and 22 a, respectively. Because opening 80 a in cross member 36 is slotted, cross member 36 may simply be loosened from clamp 28 and rotated about set screw 90 of clamp 24 so that cross member 36 is parallel to and still attached to clamp 24 and sub-member 20 b. Similarly, cross member 38 may be removed from clamp 26 and rotated about set screw 90 of clamp 30 so that cross member 38 is parallel to and still attached to clamp 30 and sub-member 22 b. Thus, the four pieces of apparatus 18 may be easily transported because of their relatively short length and light weight. The four pieces may be easily assembled to a litter 10 or other patient carrier.

In some instances, one may desire a surgical bar or rail 40 or 42 only on one side of litter 10. In that case, one may use one side of apparatus 18, that is, one longitudinal member 20 or 22 with its corresponding surgical rail 40 or 42 and the corresponding clamps. In addition, the cross bars 36, 38 are used and are fixed to the opposite pole 12 of the litter 10 using the clamps, set screws 90 and lock nuts 88, without a longitudinal member and surgical rail.

Surgical rail apparatus 18 enables the attachment of surgical devices such as retractors, light systems, monitors, suction devices, IV poles, and other surgical devices that may be needed for surgery to a litter or stretcher. Apparatus 18 enables any litter or stretcher to be easily converted into an operating table. In rural and austere settings where both military and aid relief providers may be practicing, apparatus 18 provides a means to increase the number of operating tables. Surgeons can easily attach the surgical rail apparatus 18 to any litter or stretcher and attach any surgical devices needed to the apparatus 18, thereby enabling the surgeons to operate immediately.

When assembled to a litter, surgical rail apparatus 18 provides a surgical platform in mobile environments and/or space limited areas, such as the back of a truck, a helicopter, an airplane, a boat, a train, etc. Apparatus 18 may be easily removed from a litter, packaged up, moved to a new location and used on another stretcher. This capability is important if the current surgical environment becomes unsafe or unusable due to power outages, enemy presence, lack of patients or resources, natural disaster, fire, etc.

In a non-military setting, there are incidents throughout the world that often overwhelm the host nation's abilities and resources. When international aid missions are deployed they are often limited in their ability to provide ICU (Intensive Care Unit) and surgical capabilities. This is due to the cumbersome amount of equipment and supplies needed to support an ICU or OR (Operating Room). The present invention is lightweight and easily portable and can transform any litter into an ICU bed or operating room table, thus allowing for improved care during international/national crisis. The surgical rails are also the same standard dimension and size used for OR tables around the western world and therefore can immediately accept thousands of already existing medical devices for use in OR and ICU settings. Healthcare providers that deploy around the world to austere, hostile, or mobile environments can now convert any litter into a functional ICU or OR capable bed and use the same equipment that they use in their primary practice.

Surgical rail apparatus 18 may also enable one to fix legs (not shown) to the longitudinal members 20, 22 of the apparatus 18 so that the litter may be elevated to a functional height for surgical procedures. Rail apparatus 18 provides stability to the litter, allowing the litter to be elevated above the ground level. The surgical rail apparatus 18 may also enable one to attach support rods (not shown) to the longitudinal members 20, 22 so that multiple litters may be stacked on top of each other. The stacked litters retain the ability to hold multiple medical devices on the surgical rails of the apparatuses 18, which is important when the surgical/medical devices must remain in place during transportation of the patients on the litters. In addition to enabling stacking, the surgical rail apparatus 18 provides multiple points for stabilizing and securing the litter and apparatus 18 combination to the floor, walls, ceilings, etc. of different transportation platforms.

FIG. 7 is a top perspective view of another embodiment of a surgical rail apparatus 100. Apparatus 100 may be used with litter 10 (FIG. 1) having a pair of parallel poles 12. Apparatus 100 includes a longitudinal rectangular bar 140. Preferably, bar 140 is a standard surgical rail. A first clamp 124 has a circular inner surface 132 a and an opening 134 a for receiving one of the pair of parallel poles 12. The first clamp 124 is fixed to the rectangular bar 140 on a side of the first clamp 124 that is opposite the circular inner surface 132 a. Bar 140 may be fixed to clamp 124 using a threaded fastener 176. Preferably, first clamp 124 is fixed to an approximate midpoint of rectangular bar 140. A spacer 172 is disposed between clamp 124 and bar 140. Spacer 172 creates a gap between bar 140 and clamp 124 so that medical/surgical devices may be attached and mounted on bar 140.

A second clamp 126 has a circular inner surface 132 b and an opening 134 b for receiving the other of the pair of parallel poles 12. A cross bar 136 extends between and is fixed to the first and second clamps 124, 126. Cross bar 136 may be formed with or without lightening holes 150. Clamps 124, 126 may be fixed to parallel poles 12 of litter 10 using, for example, threaded set screws 190 having thumb wheels or turning knobs 192. Each clamp 124, 126 includes a threaded opening 102 for receiving the threaded set screw 190. Threaded set screws 190 also fix cross bar 136 to clamps 124, 126 via threaded opening 102.

To use apparatus 100, rectangular bar 140 is disposed outboard of one of the parallel poles 12 and the first and second clamps 124, 126 are fixed to opposite ones of the parallel poles 12. The cross bar 136 extends under a bed 14 of the litter 10. Multiple apparatus 100 may be used with a single litter 10. Also, apparatus 100 may be used without bar 140 when another apparatus 100 with a bar 140 is used at an opposite end of litter 10. The apparatus 100 without the bar 140 functions to maintain the litter 10 in a horizontal position. In one embodiment, a bar 140 may also be fixed to second clamp 126.

FIG. 7A is a top perspective view of another embodiment of a surgical rail apparatus 200. Apparatus 200 may be used with litter 10 (FIG. 1) having a pair of parallel poles 12. FIG. 8 is a bottom perspective view of FIG. 7A. FIG. 9 is a top perspective view of the surgical rail apparatus 200 of FIG. 7A installed on the litter 10 of FIG. 1. FIG. 10 is a bottom view of FIG. 9.

Apparatus 200 includes a rectangular bar 140. Preferably, bar 140 is a standard surgical rail. A first clamp 224 has a circular inner surface 232 a and an opening 234 a for receiving one of the pair of parallel poles 12. The first clamp 224 is fixed to the rectangular bar 140 on a side of the first clamp 224 that is opposite the circular inner surface 232 a. Bar 140 may be fixed to clamp 224 using a threaded fastener 176. Preferably, first clamp 224 is fixed to an approximate midpoint of rectangular bar 140. A spacer 172 is disposed between clamp 124 and bar 140. Spacer 172 creates a gap between bar 140 and clamp 124 so that medical/surgical devices may be attached and mounted on bar 140.

A second clamp 226 has a circular inner surface 232 b and an opening 234 b for receiving the other of the pair of parallel poles 12. A pivoting cross bar 236 extends between and is fixed to the first and second clamps 224, 226. Cross bar 236 may be formed with or without lightening holes 150. Clamps 224, 226 may be fixed to parallel poles 12 of litter 10 using, for example, threaded set screws 90 having thumb wheels or turning knobs 92. The ends of cross bar 236 may be fixed to clamps 224, 226 using, for example, lock nuts 88. Each lock nut 88 includes a knob 94, a protuberance 96 beneath the knob 94, and a threaded through hole 98 (See exploded view of FIG. 6). Protuberances 96 may have smaller diameters than knobs 94 to facilitate grasping knobs 94 with one's fingers. Protuberances 96 are seated in openings 78 a, 80 a (see FIG. 6) in the flattened end portions of cross bar 236. Lock nuts 88 are tightened using knob 94 to thread lock nuts 88 on set screws 90. When lock nut 88 at clamp 224 is loosened, cross bar 236 can pivot such that cross bar 236 is substantially parallel to bar 140. This pivoted position of cross bar 236 is useful for transportation and storage of apparatus 200.

To use apparatus 200, rectangular bar 140 is disposed outboard of one of the parallel poles 12 and the first and second clamps 224, 226 are fixed to opposite ones of the parallel poles 12. The cross bar 236 extends under a bed 14 of the litter 10. FIG. 9 is a top perspective view of the surgical rail apparatus 200 of FIG. 7A installed on the litter 10 of FIG. 1. FIG. 10 is a bottom view of FIG. 9. Multiple apparatus 200 may be used with a single litter 10. Also, apparatus 200 may be used without bar 140 when another apparatus 200 with a bar 140 is used at an opposite end of litter 10. The apparatus 200 without the bar 140 functions to maintain the litter 10 in a horizontal position. In one embodiment, a bar 140 may also be fixed to second clamp 226.

FIG. 11 is a top perspective view of another embodiment of a surgical rail apparatus 300. FIG. 12 is a bottom perspective view of FIG. 11. FIG. 13 is a top perspective view of the surgical rail apparatus 300 of FIG. 11 installed on the litter 10 of FIG. 1. FIG. 14 is a bottom perspective view of FIG. 13. FIG. 15A is a bottom plan view of FIG. 14. FIG. 15B is an elevation view of FIG. 15A. FIG. 15C is an enlarged view of Detail C of FIG. 15A. FIG. 15D is an enlarged view of Detail D of FIG. 15B. Apparatus 300 includes a clamp, a portion of a cross bar and a rectangular bar or surgical rail. At least two apparatus 300 are needed for use with litter 10. Additional even numbers of apparatus 300 may be added to litter 10 and the surgical rails connected together.

Apparatus 300 includes clamp 224 fixed to a surgical rail 340 with, for example, fastener 176. A spacer 172 is disposed between clamp 224 and rail 340. Spacer 172 creates a gap between rail 340 and clamp 224 so that medical/surgical devices may be attached and mounted on rail 340. A pivoting cross bar portion 336 is fixed to clamp 224 as shown and described with respect to cross bar 236 and clamp 224 in apparatus 200 above. Similarly, pole 12 of litter 10 is fixed to clamp 224 as described with respect to apparatus 200 above.

Rail 340 includes a male end 342 and a female end 344. Female end 344 is configured to receive the male end 342 of an adjacent rail 340. Male end 342 includes a pair of opposing latching indentations 346 and female end 344 includes a pair of opposing spring-loaded latches 348. Latches 348 are configured to latch in the latching indentations 346. Rail 340 may include notches 350, as is known in the art.

FIG. 13 shows a pair of apparatus 300 fixed to a litter 10 with the male and female ends 342, 344 of the respective rails 340 of the apparatus 300 engaged. FIG. 15B is an elevation view showing the rails 340 engaged and FIG. 15D is an enlarged view of the engaged rails 340 of FIG. 15B.

As shown in FIGS. 11 and 12, pivoting crossbar portion 336 has an end 352 configured to join another pivoting crossbar portion 336. End 352 includes a projecting male portion 354 and a recessed female portion 356. Projecting male portion 354 of a first crossbar portion 336 fits into an opening in the recessed female portion 356 of a second crossbar portion 336. Projecting male portion 354 may be tapered to more easily fit in recessed female portion 356. Similarly, the recessed female portion 356 of the first crossbar portion 336 receives the projecting male portion 354 of the second crossbar portion 336. A top surface 358 (“top” refers only to the orientation of the apparatus 300 shown in FIG. 11) of crossbar portion 336 includes a latch receiver 360 and a latch 362. Latch receiver 360 is disposed on the projecting male portion 354 and latch 362 is disposed on the recessed female portion 356. Latch receiver 360 on the male portion of a first crossbar portion 336 is configured to latch with the latch 362 on the female portion of a second crossbar portion 336 and vice versa. Latch 362 and latch receiver 360 may be of the type used on some ammunition cans. Other types of suitable latching mechanisms may also be used.

FIG. 14 shows two apparatus 300 mounted on a litter 10 with their respective crossbar portions 336 latched together with latch receivers 360 and latches 362. FIG. 15A is a bottom plan view of FIG. 14 and FIG. 15C is an enlarged view of the engaged crossbar portions 336 of FIG. 15B.

Many changes in the details, materials, steps and arrangement of parts described herein may be made by those skilled in the art within the principle and scope of the invention, as expressed in the appended claims. For example, various types of fasteners and latches may be used and the components of the apparatus may have shapes and relative sizes that differ from the embodiments shown in the drawings. 

What is claimed is:
 1. An apparatus for use with a litter having a pair of parallel poles, comprising: a longitudinal rectangular bar having a cross-section of one of a North American standard surgical rail and a European standard surgical rail; a first clamp having a circular inner surface and an opening for receiving one of the pair of parallel poles, the first clamp being fixed to the longitudinal rectangular bar on a side of the first clamp that is opposite the circular inner surface; a second clamp having a circular inner surface and an opening for receiving the other of the pair of parallel poles; a cross bar extending between and fixed to the first and second clamps; each clamp including a threaded set screw for fixing the clamp to a respective one of the parallel poles; and each clamp including a threaded opening for receiving the threaded set screw and further wherein the threaded set screw fixes the cross bar to the clamp.
 2. The apparatus of claim 1, wherein the first clamp is fixed to an approximate midpoint of the longitudinal rectangular bar.
 3. The apparatus of claim 1, wherein each threaded set screw includes a thumb wheel for rotating the threaded set screw.
 4. The apparatus of claim 1, further comprising the litter wherein the longitudinal rectangular bar is disposed outboard of the one of the parallel poles, the first and second clamps are fixed to opposite ones of the parallel poles, and the cross bar extends under a bed of the litter.
 5. An apparatus for use with a litter having a pair of parallel poles, comprising: a longitudinal rectangular bar having a cross-section of one of a North American standard surgical rail and a European standard surgical rail; a first clamp having a circular inner surface and an opening for receiving one of the pair of parallel poles, the first clamp being fixed to the longitudinal rectangular bar on a side of the first clamp that is opposite the circular inner surface; a second clamp having a circular inner surface and an opening for receiving the other of the pair of parallel poles; a cross bar extending between and fixed to the first and second clamps; each clamp including a threaded set screw for fixing the clamp to a respective one of the parallel poles; and each clamp including a lock nut having a protuberance disposed in an opening in the cross bar for securing the cross bar to the clamp wherein the threaded set screw engages a threaded opening in the lock nut.
 6. An apparatus for use with a litter having a pair of parallel poles, comprising: a longitudinal rectangular bar having male and female ends, the male end including a pair of latch indentations and the female end including a pair of spring-loaded latches wherein the pair of spring-loaded latches on the female end are configured to latch with a pair of latch indentations on a male end of a second rectangular bar; a clamp having a circular inner surface and an opening for receiving one of the pair of parallel poles, the clamp being fixed to the longitudinal rectangular bar on a side of the clamp that is opposite the circular inner surface; and a cross bar portion extending from the clamp and having an end distal the clamp wherein the distal end includes a projecting male portion and a recessed female portion, the projecting male portion configured to mate with an opening in a recessed female portion of a second cross bar portion and the recessed female portion configured to mate with a projecting male portion of the second cross bar portion.
 7. The apparatus of claim 6, wherein the cross bar portion includes a latch receiver disposed on the projecting male portion and a latch disposed on the recessed female portion wherein the latch receiver and latch are configured to latch with a latch and latch receiver, respectively, on the second cross bar portion.
 8. The apparatus of claim 6, wherein the longitudinal rectangular bar has a cross-section of one of a North American standard surgical rail and a European standard surgical rail.
 9. The apparatus of claim 7, wherein the clamp includes a threaded set screw for fixing the clamp to a respective one of the parallel poles.
 10. The apparatus of claim 9, wherein the clamp is fixed to an approximate midpoint of the longitudinal rectangular bar.
 11. The apparatus of claim 10, wherein the clamp includes a lock nut having a protuberance disposed in an opening in the cross bar portion for securing the cross bar portion to the clamp.
 12. The apparatus of claim 11, wherein the threaded set screw engages a threaded opening in the lock nut.
 13. A device, comprising: a first apparatus according to claim 7; a second apparatus according to claim 7; and the litter having the pair of parallel poles; wherein, the clamp of the first apparatus is fixed to one of the parallel poles and the clamp of the second apparatus is fixed to the other of the parallel poles, the projecting male portion of the cross bar portion of the first apparatus is inserted in the recessed female portion of the cross bar portion of the second apparatus, and the projecting male portion of the cross bar portion of the second apparatus is inserted in the recessed female portion of the cross bar portion of the first apparatus.
 14. The device of claim 13, wherein, the latch disposed on the recessed female portion of the cross bar portion of the first apparatus is latched to the latch receiver disposed on the protruding male portion of the cross bar portion of the second apparatus and the latch disposed on the recessed female portion of the cross bar portion of the second apparatus is latched to the latch receiver disposed on the protruding male portion of the cross bar portion of the first apparatus.
 15. The device of claim 14, wherein the rectangular bars of the first and second apparatus have cross-sections of one of North American standard surgical rails and European standard surgical rails.
 16. The device of claim 15, wherein the cross bar portions of the first and second apparatus extend under a bed of the litter. 